Ovbiagele Bruce, Hills Nancy K, Saver Jeffrey L, Johnston S Claiborne
Stroke Center and Department of Neurology, University of California at Los Angeles Medical Center, Los Angeles, California, USA.
J Stroke Cerebrovasc Dis. 2006 Nov-Dec;15(6):260-5. doi: 10.1016/j.jstrokecerebrovasdis.2006.06.006.
We sought to evaluate whether differential antihypertensive responsiveness in blacks is reflected in discharge antihypertensive prescription patterns among patients hospitalized with an ischemic cerebrovascular event.
We analyzed use of discharge antihypertensive medications among patients hospitalized with an ischemic cerebrovascular event in the California Acute Stroke Prototype Registry, examining rates in black patients compared with all other races combined. Generalized estimating equations were used to identify factors independently associated with receipt of any antihypertensive medication overall and with use of specific types of antihypertensives.
Data were collected on 794 consecutive patients treated at 11 hospitals. No significant differences were observed between rates of antihypertensive use in black patients (74%) when compared with all others (69%), either for overall use or for any specific category of antihypertensive, although there was a trend toward more frequent use of diuretics in black patients (P = .12). Results were similar when analysis was limited to those with a history of hypertension.
In spite of a known differential response to antihypertensives in blacks, we found no differences in discharge antihypertensive prescription patterns in black patients hospitalized with transient ischemic attack and ischemic stroke compared with other races.
我们试图评估黑人患者在降压反应上的差异是否体现在因缺血性脑血管事件住院患者的出院降压处方模式中。
我们分析了加利福尼亚急性卒中原型登记处中因缺血性脑血管事件住院患者出院时降压药物的使用情况，将黑人患者的使用率与其他所有种族合并后的使用率进行比较。使用广义估计方程来确定与总体接受任何降压药物以及使用特定类型降压药物独立相关的因素。
收集了11家医院794例连续治疗患者的数据。黑人患者的降压药物使用率（74%）与其他所有患者（69%）相比，无论是总体使用还是任何特定类别的降压药物使用，均未观察到显著差异，尽管黑人患者使用利尿剂的频率有更高的趋势（P = 0.12）。当分析仅限于有高血压病史的患者时，结果相似。
尽管已知黑人对降压药物的反应存在差异，但我们发现因短暂性脑缺血发作和缺血性卒中住院的黑人患者与其他种族相比，出院降压处方模式没有差异。
